Wiki BCBS of TX & BCBS of IL

[Missy13]

Does anyone know how to get to speak to a live person - rep at BCBS of TX and BCBS of IL. My provider is receiving the checks from those two insurances without remittance advice. We can not verify these checks on Availity. I tried calling many BCBS ph# for TX and IL and when I get to claims status option it directs me to Availity, but there is nothing coming through Availity for BCBS. It's been very frustrating trying to speak to someone and not being able to. I have been transferred from one call to another several times without success. Please help!!

 

[thomas7331]

I can't help with the phone issue, but I've used Availity for this purpose without any major problems. The remittance advices won't necessarily come via the Availity electronic system (at least not my provider's practice - I have to go to their web site and retrieve them). Have you already created an online account for the Availity internet portal? If not, you'll have to do that first. The navigation to the reports where the remittances are stored is a little tricky, but here are the instructions on how to get to them: https://www.bcbstx.com/docs/provider/tx/education/tools/remittance-viewer-tip-sheet.pdf

If you've already done all that and still can't access them, I'm afraid I can't help much more, but you probably do need to talk to Availity and not to BCBS. On the portal, under the 'Help & Training' tab, select 'Availity Support'. It will take you a page with demos and additional training and if that's not sufficient, there's a link to 'contact support' with options to chat or open a case or call the Availity phone number. If you're being transferred repeatedly to people who can't help, then insist that the rep stay on the line until they get to the right person. If that doesn't work, ask to speak to a supervisor or a network representative, if you have one.

 

[mmyoung]

If it's a commercial plan: 800/451-0287

You will need to call in with a claim number in order to get ahold of an actual person. I suggest calling with a serious inquiry about a claim then asking the representative for guidance on your situation.

Another option would be to send a certified letter to the address the check came from that requests an explanation of payment.

If there's no RA, my guess is the checks may be related to Texas prompt pay laws. That should come with a letter of explanation.